Researchers from the University of Saskatchewan, Ernesto Figueiro-Filho, and Karolina Grzyb, delve into the significance of placental growth factor (PLGF) in screening for preeclampsia and adverse obstetric outcomes, particularly in diabetic populations.
Preeclampsia, a prevalent pregnancy complication affecting 2-8% of pregnancies after 20 weeks, is often asymptomatic, characterized by gestational hypertension, proteinuria, and adverse conditions. Detecting preeclampsia early during routine prenatal testing is crucial due to its asymptomatic nature. The management goal for individuals with preeclampsia is to monitor maternal-fetal complications and reach the minimum safe gestational age for delivery.
Recent research emphasizes PLGF as a promising biomarker for predicting, diagnosing, and managing preeclampsia. Dysregulation of placental development, where PLGF plays a pivotal role, can lead to severe complications, making it a crucial factor in assessing pregnancy risks.
In a healthy pregnancy, PLGF concentrations vary across trimesters, peaking at the 30th week. PLGF is considered a major predictor of adverse obstetrical outcomes, such as preeclampsia, fetal growth restriction (FGR), preterm birth, and stillbirth.
Preliminary data collected by the University of Saskatchewan’s research group on PLGF testing reveals that 50% of patients with borderline low, low, or very low PLGF levels are at a higher risk of developing pregnancy complications. For those with low PLGF levels, the average onset of preeclampsia occurs at 28 weeks, indicating a potential correlation between PLGF levels and the timing of preeclampsia onset.
In Saskatchewan, where approximately 27% of the population has diabetes or prediabetes, and Indigenous populations face an elevated risk, the researchers found a statistically significant association between preeclampsia and diabetes. Low/very low PLGF levels were identified in 63% of patients with gestational diabetes (GDM), 27% with type 2 diabetes, and 10% with type 1 diabetes.
The study further revealed that low/very low PLGF levels were linked to worse perinatal outcomes, including increased rates of preterm births, lower gestational age at delivery, and higher rates of cesarean sections. On the contrary, normal PLGF levels correlated with favorable outcomes, including no preeclampsia, no FGR, and term deliveries with normal neonatal birth weight.
Looking ahead, the research group aims to continue their investigations, supported by a grant from the Saskatchewan Health Research Foundation. Plans include a randomized clinical trial to explore the potential benefits of low molecular heparin associated with aspirin in patients with low PLGF, with the goal of improving pregnancy and perinatal outcomes. Additionally, the research contributes to implementing PLGF testing in Saskatchewan, establishing it as a routine test for managing high-risk pregnancies, especially in rural areas.
